APPLICATION FOR MINOR VARIANCE or RELIEF FROM MUNICIPAL CODE SIGN or FENCE REGULATION

APPLICATION FOR MINOR VARIANCE or RELIEF FROM MUNICIPAL CODE SIGN or FENCE REGULATION Section 45 of the Planning Act, R.S.O. 1990 & City of Brantford Bylaw 28-90, as amended (Chapters 437, 438 & 478 of the Municipal Code) CONSULTATION WITH CITY STAFF IS ENCOURAGED PRIOR TO SUBMISSION OF THIS APPLICATION FORM This development application must be typed or printed in black or blue ink. All applications must be signed. This application form be found online at: http://www.brantford.ca/population%20projections%20%20documents/application_relieffrom ZoningBylaw.pdf Check off all that apply: Section 45(1) of the Planning Act Section 45(2) of the Planning Act: Enlargement or Extension of Legally Established n-conforming Use [Section 45(2)(a)(i) of the Planning Act] Change of Legally Established n-conforming Use [Section 45(2)(a)(ii) of the Planning Act] Bylaw Clarification for uses, buildings and structures defined in general terms [Section 45(2)(b) of the Planning Act] Office Use: File Numbers: Related File: Application Submitted: Complete Application: Roll. / Area: a) Have you had a Formal Pre-consultation meeting with the City of Brantford prior to submitting this application? (If yes, please attach record/notes of Formal Pre-consultation to application). b) Have the required studies, plans or reports been submitted? c) Is the survey sketch attached? Chapter 437 of the Municipal Code (Fences/Gates around Swimming pools) Chapter 438 of the Municipal Code (Fences Height Regulation) Chapter 478 of the Municipal Code (Signs-Outdoor) PART I CONTACT INFORMATION 1. Name of Applicant 1 Phone Address City/Postal Code Fax E-mail 1 If the applicant is a numbered company, also provide the name of a principal of the company. 2. Name of Agent Phone Address City/Postal Code Fax E-mail 3. Name of Property Owner 2 Phone Address City/Postal Code Fax E-mail 2 It is the responsibility of the owner or applicant to notify the Planner of any changes in ownership within 30 days of such a change. 4. Date the property was acquired by the owner? 5. Please specify to whom all communications should be sent to. 3 Agent Applicant Owner 3 Unless otherwise directed, all correspondence, notices, etc. in respect of this development application will be forwarded to the Applicant noted above, except where an Agent is employed, then such will be forwarded to the Applicant and Agent. Page 1 of 11

PART II GENERAL PROPERTY DESCRIPTION 1. Municipal Address 2. Legal Description (fill in all that are applicable) Concession Registered Plan. Reference Plan. Lot Number(s) Lot(s)/Block(s) Part(s) 3. Property Dimensions (in metric units) Frontage/Width (m) Depth (m) Area (m 2 /ha) 4. Encumbrances Are there any mortgages, easements or restrictive covenants affecting the subject land? If yes, provide names and addresses of the holders of any mortgages, charges or other encumbrances in respect of the subject lands. 5. Existing Use of Property Agricultural Commercial Industrial Institutional Residential Vacant Other(s) How long have the lands been used for the above purpose? 6.a Previous Use of Property Agricultural Commercial Industrial Institutional Residential Vacant Other(s) If Industrial or Commercial, specify use: 6.b Details of Previous Uses Has the grading of the subject land been changed by adding earth or other material, i.e. has filling occurred? Has a gas station been located on the subject land or adjacent lands at any time? Has there been petroleum or other fuel stored on the subject land or adjacent lands? Are there or have there ever been underground storage tanks or buried waste on the subject land or adjacent lands? Have the lands or adjacent lands ever been used as an agricultural operation where cyanide products may have been used as pesticides and/or sewage sludge was applied to the lands? Have the lands or adjacent lands ever been used as a weapons firing range? Is the nearest boundary line of the subject lands within 500 metres (1,640 feet) of the fill area of an operational/non-operational landfill or dump? If there are existing or previously existing buildings, are there any building materials remaining on site which are potentially hazardous to public health (i.e., asbestos, PCB s)? Is there a reason to believe the subject land may have been contaminated by former uses on the site or adjacent sites? Unknown What information did you use to determine the answers to 6 above? If you answered to any of the questions in Section 6 of this application, a previous use inventory showing all known former uses of the subject lands, or if appropriate, the adjacent lands, is needed. Is the Previous Use Inventory attached? Page 2 of 11

7. List any Existing Buildings or Structures on the Subject Lands Type of Buildings or Structures When Built (approx.) To Be Retained ( / ) 1. 2. 3. 8. Servicing, Drainage and Access Indicate what services are available or proposed: Water Supply Sewage Treatment Storm Drainage Municipal water Municipal sewers Storm sewers Communal wells Communal system Open ditches Individual wells Septic tank and tile bed Other (describe below) Has the existing drainage on the subject lands been altered? Does a legal and adequate outlet for storm drainage exist? Unknown Are the subject lands within an area that is subject to the regulations of the Grand River Conservation Authority (GRCA)? If yes, please note that the GRCA may require additional fees for the processing of your application. For more information, please check the following link: http://www.grandriver.ca/index/document.cfm?sec=17&sub1=71 Have you consulted with GRCA? Existing or proposed access to subject lands: Unopened road Municipal road Provincial highway Private Road Name of road/street: PART III DETAILS OF THE PROPOSAL 1. Please provide a complete written description of the application with details of the proposed development including, but not limited to: proposed use(s), development details (i.e. height/storeys, floor area(s), number of parking/loading spaces, lot coverage, landscape area, etc.) If additional space is needed, please attach a separate page. Page 3 of 11

2. Please describe the variance(s) you are seeking. To assist, please complete the relevant sections of the Zoning Checklist attached as Appendix A to this application. The information on the checklist is then used to describe the requested relief you are seeking from the Zoning Bylaw. Planning Staff can help with this section. Some examples of how to write out your requested variance(s) are listed below: a) To permit a lot width of m, whereas the Zoning Bylaw requires m. OR b) To permit parking spaces, whereas the Zoning Bylaw requires parking spaces. OR c) To seek relief from Section of the Zoning Bylaw to permit etc. 3. Please explain the nature and extent of the requested relief of the Municipal Code: 4. Please explain why it is not possible to comply with the provision(s) of the Zoning By-law or Municipal Code: 5. Please provide any additional information which may assist staff and other agencies in reviewing this application. If additional space is required, please attach a separate page. PART IV ADDITIONAL INFORMATION Are there any other applications by the applicant for the subject lands, or for lands within 120 metres of the subject lands for any of the following: Consent (Severance) Amendment to Official Plan Amendment to Zoning Bylaw Minister s Zoning Order Approval of a Plan of Subdivision Approval of a Plan of Condominium Site Plan Other: File Number Status of Application Page 4 of 11

PART V PROVINCIAL AND MUNICIPAL POLICY te: Assistance is available from Planning Staff to help complete this section. 1. What is the current Official Plan designation of the subject property? 2. What is the current zoning on the subject property? 3. Is this application consistent with the Provincial Policy Statements issued under subsection 3(1) of the Planning Act? 4. Is the subject land within an area designated or identified under any of the following: Intensification Area as identified in the Official Plan Downtown Master Plan Other (specify) Waterfront Master Plan Secondary Plan 5. Heritage Features Are there any buildings or structures on the subject lands that are subject to a Heritage Easement or have been designated under Part IV or Part V of the Ontario Heritage Act? Are there any buildings or structures on the abutting lands that are subject to a Heritage Easement or have been designated under Part IV or Part V of the Ontario Heritage Act? If yes to either of the above, a Heritage Impact Assessment may be required. Is a Heritage Impact Assessment attached? 6. Endangered Species Act Requirement The Ministry of Natural Resources recommends that municipalities advise proponents to undertake a preliminary ecological site assessment for Species at Risk and their habitat. It is important that you, as the applicant, be aware of the Endangered Species Act and how it may affect your development application. It will be at your discretion to undertake an informal assessment of your property to get a better understanding of the type of species that inhabit your property and if any of these species are classified as species at risk. This will help you to determine if there is a need for a formal assessment to accompany your development application. Further information is attached in Appendix B of this form, and you can also consult Planning Staff, or contact the MNR district office at 519-826-4255 or the MNR SAR website at Ontario.ca/speciesatrisk. Are you aware of any species at risk in your property? If so, have you undertaken an informal assessment? Is a formal assessment necessary? 7. Significant Features All applications under the Planning Act are subject to review for regard to the Provincial Policy Statement issued by the Province of Ontario. COMPLETE the table (on the reverse side) and be advised that additional information may be required. If the information is not submitted, it may not be possible to do a complete and proper planning evaluation. Page 5 of 11

Use or Feature TABLE SIGNIFICANT FEATURE CHECKLIST Is it on site or within 500 m? (X) (X) Specify Distance in Metres Details of Potential Studies/Required Information Class 1 industry 1 Assess development for residential and other sensitive uses within 70 metres Class 2 industry 2 Assess development for residential and other sensitive uses within 300 metres Class 3 industry 3 within 1000 metres Assess development for residential and other sensitive uses within 1000 metres Landfill Site Address possible leachate, odour, vermin and other impacts Sewage Treatment Plant Waste Stabilization Pond Active Railway Line Controlled access highways or freeways, including designated future routes Electric transformer station High voltage electric transmission line Transportation and infrastructure corridors Mineral aggregate resource areas Existing Pits and Quarries Mineral and petroleum resource areas Significant wetlands or potentially significant wetlands Significant portions of habitat of endangered species & threatened species Significant fish habitat, woodlands, valley lands, areas of natural and scientific interest, wildlife habitat Significant groundwater recharge areas, headwaters and aquifers Significant landscapes, vistas, significant cultural heritage landscapes Significant archaeological resources Abandoned landfill sites Assess the need for a feasibility study for residential and other sensitive land uses Assess the need for a feasibility study for residential and other sensitive land uses Evaluate impacts within 100 metres ise study prepared? Consultation with CN? Evaluate impacts within 100 metres Determine possible impacts within 200 metres Consult Brantford Power Will the corridor be protected? ise study prepared? Will development hinder access to the resource or the establishment of new resource operations? ise & dust study completed? Will development hinder continued operation or extraction? ise and dust study completed? Will development hinder access to the resource or the establishment of new resource operations? Development is not permitted within Provincially Significant Wetlands. Provide Environmental Impact Study Provide Environmental Impact Study Provide Environmental Impact Study. Tree Inventory? Tree Preservation Plan? Demonstrate that these features will be protected Development should conserve significant landscapes, vistas, significant built heritage resources and cultural heritage landscapes Assess development proposed in areas of medium and high potential for significant archaeological resources. These resources are to be studied and preserved, or, where appropriate, removed, catalogued and analyzed prior to development. Which category? Investigation/remedial measures Erosion hazards Floodplains, Floodway Policy Area Special Policy Area (SPA1), (SPA2) Hazardous sites 4 Contaminated sites Determine feasibility within the 1:100 year erosion limits of ravines, river valleys and streams Must meet the Official Plan policies Demonstrate that hazards can be addressed (slope study, flood line study) Inventory of previous uses in areas of possible soil contamination, record of site condition, affidavit Agricultural Operations Development to comply with the minimum distance separation formulae and Official Plan policies 1 Class 1 industry: Small scale, self-contained plant, no outside storage, low probability of fugitive emissions and daytime operations only. 2 Class 2 industry: Medium scale processing and manufacturing with outdoor storage, periodic output of emissions, shift operations and daytime truck traffic. 3 Class 3 industry: Indicate if within 1000 metres. Processing and manufacturing with frequent and intense off-site impacts and a high probability of fugitive emissions. 4 Hazardous sites: Property or lands that could be unsafe for development or alteration due to naturally occurring hazard. These hazards may include unstable soils, unstable bedrock, or steep slopes. Page 6 of 11

PART VI SUPPORTING MATERIAL TO BE SUBMITTED BY APPLICANT 1. Application Fee. 2. Five (5) copies of all required studies, plans or reports identified through the Pre-consultation process, in both paper and electronic, preferably PDF layers and CAD format. 3. Two (2) copies of the completed, signed application form. 4. Two (2) copies of the cover letter briefly outlining the purpose of the application. 5. Two (2) copies of a plan, survey or a boundary description drawn to scale by an Ontario Lands Surveyor (O.L.S.) that accurately and sufficiently identifies all dimensions and any existing structures on the subject property, including: the boundaries and principal dimensions of the property; an illustration and dimensions of the lands to be severed and retained or the proposed easement/right of way (if applicable); the location of any existing easements, deed restrictions, encroachments, or public regulations (other than those of the Zoning Bylaw or Official Plan) which may limit the use of the land; and for each existing building or structure: the type of building or structure: the setback from the front lot line, rear lot line and side lot lines; the height in metres of the building or structure; and if required, the dimensions and/or floor areas of the building or structure. 6. Two (2) copies of a plan metric units illustrating the proposed development, if required, showing: for each proposed building or structure: the type of building or structure; the setback from the front lot line, rear lot line and side lot lines; the height in metres of the building or structure; and the dimensions or floor area of the building or structure; the approximate location of all natural and artificial features on the subject lands and on land that is adjacent to the subject lands that, in the opinion of the applicant, may affect the application. Examples include buildings, railways, roads, watercourses, drainage ditches, river or stream banks, wetlands, wooded areas, wells and septic tanks. the current uses on the land that is adjacent to the subject land. the location, width and name of any roads within or abutting the subject lands, indicating whether it is an unopened road allowance, a public travelled road, a private road or a right of way. lot coverage and gross floor areas in square metres for all buildings and structures; location and dimensions of off-street parking areas and parking structures, the number of parking spaces to be provided, and ingress and egress to public streets; any pylon signs, fascia signs, light standards, etc., and their location; and garbage collection and other outdoor storage areas. PART VII NOTIFICATION SIGN REQUIREMENTS For the purpose of public notification and to assist staff with locating your lands, you must post a sign to indicate the intent and purpose of your development application. It is your responsibility to: 1. Post a minimum of one sign per frontage in a visible location on the subject lands, as near to the street as feasible and facing the street. The sign must be erected so that it can be read by someone walking or driving by the subject lands. 2. Ensure one sign is posted at the front of the subject lands no more than 2.0 metres above grade. 3. tify the Planner when the sign is in place in order to avoid processing delays and provide a photograph to the Planner of the sign confirming that it has been erected. 4. Maintain the sign until the appeal period has expired whereupon you will remove the sign. Planning staff will provide the sign(s) and instructions regarding their location. Failure to erect the sign properly and maintain the sign may result in delays of the processing of your application. Page 7 of 11

PART VIII ACKNOWLEDGEMENT 1. PERMISSION TO ENTER SUBJECT LANDS Permission is hereby granted to City of Brantford staff and members of the Committee of Adjustment to enter the premises subject to this development application for the purposes of making inspections associated with this application, during normal and reasonable working hours. Date Signature of Owner/Applicant/Agent 2. FREEDOM OF INFORMATION Application information is collected under the authority of the Planning Act, R.S.O. 1990, c.p.13. In accordance with that Act, it is the policy of the City of Brantford to provide public access to all Planning Act applications and supporting documentation submitted to the City. I,, the Owner, hereby agree and acknowledge (Print name of Owner) That the information contained in this application and any documentation, including reports, studies and drawings, provided in support of the application, by myself, my agents, consultants and solicitors, constitutes public information and will become part of the public record. As such, and in accordance with the provisions of the Municipal Freedom of information and Protection of Privacy Act, R.S.O. 1990, c.m.56, I hereby consent to the City of Brantford making this application and its supporting documentation available to the general public, including copying and disclosing the application and its supporting documentation to any third party upon their request. Date 3. ACKNOWLEDGEMENT CLAUSE Signature of Owner/Applicant/Agent I acknowledge that the City of Brantford is not responsible for identification and remediation of contamination on the property, which is the subject of this Application by reason of its approval to this Application. Date Signature of Owner/Applicant/Agent 4. AFFIDAVIT OR SWORN DECLARATION I,, of the in the make oath and say (or solemnly declare) that the information contained in this application is true and that the information contained in the documents that accompany this application is true. Sworn (or declared) before me at the in the this day of, _20. Signature of Owner/Applicant/Agent Signature of a Commissioner, etc. Page 8 of 11

5. AUTHORIZATION If the applicant is not the owner of the land that is the subject of this application, the authorization set out below must be completed. Authorization of Owner for Agent to Make the Application I,, am the owner of the land that is the subject of this application and I authorize to act as my agent in this matter and to make this application on my behalf and to provide any of my personal information that will be included in this application or collected during the processing of this application. Date Signature of Owner Page 9 of 11

Zoning Checklist (Planning staff can assist) APPENDIX A Zoning Checklist Form Lot Area 1. Property Address: 2. Zone: 3. What is the proposed/existing use: 4. Does the proposed/existing use comply with the list of Permitted Uses as noted in the zone above? Lot Width Lot Coverage Building Height Front Yard Rear Yard Side Yard - Interior Side Yard - Exterior Gross Floor Area Landscaped Open Space Amenity Space Buffering (Section 6.10) Planting Strip (Section 6.11) Open Storage (Section 6.12) Parking Number of spaces Stall size Aisle width Loading Spaces (Section 6.23) Other REQUIRED DEVELOPMENT REGULATIONS (please note that not all categories will apply to the zone that you are analyzing) Required (m/ft) Proposed (m/ft) Deficiency (m/ft) Page 10 of 11

APPENDIX B Endangered Species Act Requirements Page 11 of 11